By CRISTINA JANNEY
Hays Post
HaysMed is in negotiations with Blue Cross Blue Shield of Kansas to increase its reimbursement rates.
Michelle Beckner, HaysMed chief financial officer, said nationally, the cost of health care has increased by about 7.5%. During the same period, reimbursements to HaysMed from insurance provider Blue Cross Blue Shield of Kansas have increased by only 1-2%.
Blue Cross Blue Shield Kansas issued a written statement to the Hays Post via email on Monday afternoon.
“We are disappointed that Hays Medical Center (HaysMed) sent Blue Cross and Blue Shield of Kansas a termination notice effective Dec. 31, 2026, prior to the release of the 2027 reimbursement rates," the statement said.
"We hope they reconsider once the 2027 reimbursement rates are released. Our goal is to compensate providers fairly while being good stewards of our members' health care dollars," the statement continued.
“We deliver statewide reimbursement rates to providers in July. Providers then have until Sept. 3 to choose whether they want to remain in our network. This is the standard, annual contract procedure," the statement said.
HaysMed operating at a loss
Beckner said HaysMed is operating at a loss. However, she would not say much how much the hospital loses annually.
According to its 2023 Form 990, available through ProPublica, HaysMed had revenues of about $231.6 million but was $10.1 million short of expenses. As of its 2024 Form 990 filing, the hospital's deficit had fallen to just less than $115,000.
The hospital’s 2025 Form 990 showed HaysMed revenue had increased to $279 million, but the hospital recorded a loss of $1.29 million.
SEE RELATED STORY: HaysMed faces economic pressures, operating at a loss
“From a sustainability perspective for HaysMed, we have to come up with a different path to be sustainable,” Beckner said.
“We are not in a sustainable position right now financially, and so we are working hard to navigate all the levers that we can, from cost savings to evaluating reimbursement to making sure that we can get HaysMed into a sustainable position.”
HaysMed sent letters to Blue Cross Blue Shield members on June 17, informing them of the negotiations and urging them to contact Blue Cross Blue Shield.
Nothing has changed now, and HaysMed is still accepting Blue Cross Blue Shield insurance.
“At this point, we're actively engaged in negotiations with Blue Cross, and we maintain optimism that we'll be able to come to an agreement in good faith with Blue Cross,” Beckner said.
Beckner would not say what percentage of HaysMed patients are Blue Cross Blue Shield members, but she said it was a substantial portion.
She said HaysMed is committed to maintaining access for Blue Cross Blue Shield clients.
However, the worst-case scenario would be a failure of negotiations and HaysMed no longer accepting Blue Cross Blue Shield as an in-network insurer.
This would result in Blue Cross patients paying significantly more out of pocket for services or traveling to another hospital that accepts Blue Cross insurance in-network.
Patients speak out
The Hays Post reached out to the community via Facebook to ask how ending in-network coverage with Blue Cross Blue Shield would affect them.
Within two hours, the post had received almost 200 comments.
Many of the commenters said they would be forced to go to another hospital for services or change insurance providers.
Hannah Enslow said she would probably drive to WaKeeney, Plainville or Russell.
Kylee Kraus said, “That would be a huge disservice for everyone west of Hays! The western half of Kansas is already driving a couple of hours for care.
“If they stop accepting, that will increase to a four-to-five-hour drive to see a specialist!" she said. "I work for Ness County. We are one of the largest employers in our county, and we have BCBS. I know the other large employers in Ness County also have BCBS!”
Taylor Bahan said he wouldn’t be able to drive to another facility because of a seizure disorder.
“I would not have access to the health care I need. And if anything else happened to me like that again, I wouldn’t be able to afford the bill,” he said.
Liz Rowland Kolacny said using another hospital would be difficult for her because of her age.
“My family has always had excellent care at HaysMed. I would be very disappointed if they decided to put dollars over patients,” she said.
Jaye Ditter also said he has been satisfied with the services at HaysMed. However, he said he and others would be forced to seek care elsewhere if HaysMed can’t reach an agreement with Blue Cross Blue Shield.
“It would be very difficult, if not impossible, to afford health care without their BCBSKS insurance being accepted,” she said.
“I believe it would hurt Hays Medical Center greatly. Speaking for myself, I've been very satisfied with the care I and my family have received at Hays Medical Center, but we absolutely need our BCBSKS insurance to be accepted there to continue receiving that care. Hoping it can be worked out for both sides.”
Reimbursement rates vary among hospitals
Beckner said hospitals are experiencing the pressure of rising costs just as other businesses and families are.
HaysMed and other hospitals across the country are treating more patients with increasingly complex needs, while labor, drug and supply costs continue to rise, she said.
“That's the reason that we're working with Blue Cross to reach a fair and sustainable agreement that better reflects the cost of providing care for patients in our communities,” Beckner said. “Our goal is to find a solution that works for everyone, especially the patients and families who depend on access to local providers and services that they know and trust.”
Beckner said the funding gap is not affecting the quality of care at the hospital, right now, but could affect the hospital's ability to function in the long term.
“Today we're maintaining quality care, but five years from now, 10 years from now, 20 years from now, we need to still be able to provide really high quality care,” she said. “With the gap of inflation growing faster than reimbursement is growing, it puts that at risk in the future.”
“Our objective is to get fair payment from Blue Cross. We'll be able to continue investing in our care teams and our providers, the technology, the facilities, the services that we provide to be able to maintain the level of care that our communities have experienced and deserve to continue to experience moving forward,” Beckner said.
She said the system insurance companies use to calculate reimbursements can be varied and complicated.
However, nationwide large hospital networks tend to have more bargaining power than single hospitals or small rural networks, Beckner said.
This can result in urban hospitals being paid significantly higher reimbursement rates than rural hospitals.
“Even though both organizations are providing the same total knee surgery, they might have a different approach to how they reimburse,” Beckner said.
Although reimbursement rates have been an issue for hospitals across the country, Beckner said, “We're entering these conversations with Blue Cross, because this is where we feel like it's the biggest struggle.”
HaysMed urges members to contact BCBS
Beckner urged Blue Cross Blue Shield members, employers and managers to call the number on the back of their insurance cards and express their desire for Blue Cross Blue Shield to increase its reimbursement rates at HaysMed.
“Call Blue Cross, and just say, ‘Hey, it's important to us that we stay in network. Please continue to have conversations and negotiate with HaysMed and Pawnee Valley. It's important to us that we have access to our providers, etc,’” Beckner said.
“And so ultimately, for us, the conversation is about protecting access to local care, close to home. Hearing directly from the people who rely on that care can be valuable for Blue Cross to hear from our patients,” she said.
Beckner said the negotiation process can be lengthy. It could take several months; however, it could take much longer.
If an agreement is not reached, and you are covered under a BCBSKS commercial plan, including Affordable Care Act Marketplace plans, your access to HaysMed, Pawnee Valley Community Hospital, and our doctors, providers, and care teams may be impacted after Dec. 31, according to the HaysMed website.
The contracts last anywhere from a year to several years, depending on what the parties negotiate.
Beckner said the hospital is trying to be transparent with patients and keep them informed of the negotiations.
Beckner restated that nothing has changed for patients at this point.
“We still want our patients to continue scheduling appointments with their providers at HaysMed and Pawnee Valley,” she said. “Today, we are still accepting Blue Cross Blue Shield of Kansas insurance. We want patients to continue receiving care and scheduling appointments with their providers as they normally would. Today, everything is just the same.”
Learn more here
Anyone who would like to ask the hospital questions about the negotiations can contact the hospital’s spokesperson on its website. https://www.haysmed.com/contact-us/
The hospital has also set up an FAQ page at https://www.haysmed.com/builtforruralhealthcare/